Renouncement of renal replacement therapy: withdrawal and refusal

Moura-Neto, José A.; Moura, Ana Flávia; Suassuna, José Hermógenes Rocco

doi:10.5935/0101-2800.20170054

Cited by 6 publications

(4 citation statements)

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“…Among these, there is evidence of elderly people, with less education, who spent more time on the journey to the dialysis service, with a greater number of self-reported diseases and inadequate sleep. Even population aging and socioeconomic vulnerability, as well as the increase in DM and AH, associated with improvements in the diagnosis of CKD, have been re ected in the increase in cases with CKD (32).…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic, Clinical and Biochemical Factors Associated With the Glomerular Filtration Rate in Patients Newly Admitted to Hemodialysis in Sus

Oliveira

Cotta

Ferreira

et al. 2023

Preprint

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Background Among the chronic conditions with the greatest evidence of a multifactorial nature, both in terms of etiology and progression, Chronic Kidney Disease (CKD) stands out. The present study aims to analyze the relationship between the Glomerular Filtration Rate (GFR) and the biochemical and sociodemographic parameters in individuals recently admitted to hemodialysis.Methods This is a baseline cross-sectional design of the Nephrology Service of the health microregion of Viçosa, Minas Gerais, Brazil. Descriptive, univariate and multiple linear regression analyzes were performed. The Kolmogorov-Smirnov test was used to test the normality of continuous variables. For numeric variables, Student's t and Mann Whitney test were used. All analyzes were performed using IBM SPSS Statistics 23.0 Software.Results Data from 422 patients were included. The mean age at the onset of HD was 64.02 ± 15.21 years. Chronic hypertensive kidney disease represented 33.4% of cases with varied etiology. The average Glomerular Filtration Rate (GFR), calculated using the CKD-EPI formula, was 10.13 ml/min/1.73m² and the average survival time was 52.06 months (± 49.91%). Based on the evaluation of laboratory data, the averages that were not normal according to the recommendations for these patients were serum calcium, hemoglobin, hematocrit, serum albumin and pre-dialysis urea. Based on the results of the univariate analysis, the following variables were included in the multiple linear regression model: gender, marital status, age, nPCR, glucose, albumin, ferritin, and PTH. According to multivariate analysis, gender, marital status, nPCR, glucose and PTH were independently associated with GFR.Conclusion CKD is increasingly highlighted nowadays because it is a CNCD with a high prevalence of hospitalizations and mortality due to its multifactorial and progressive nature. Therefore, by analyzing the relationship between GFR and biochemical and sociodemographic parameters in individuals newly admitted to HD, the present study allows further insights into the mechanisms that will translate into causalities and ways to establish a better prognosis.

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Section: Discussionmentioning

confidence: 99%

Sociodemographic, Clinical and Biochemical Factors Associated With the Glomerular Filtration Rate in Patients Newly Admitted to Hemodialysis in Sus

Oliveira

Cotta

Ferreira

et al. 2023

Preprint

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“…With this context in mind, many patients have refused dialysis with the support of their families and physicians. 59 , 60 Patients refusing dialysis have their functions and symptoms relatively under control until two or three months before they die. It is the task of the physician and the multidisciplinary care team to anticipate and identify symptoms and provide the relief needed.…”

Section: Discussionmentioning

confidence: 99%

Conservative management for patients with chronic kidney disease refusing dialysis

Castro¹

2019

Braz. J. Nephrol.

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Estimates suggest that 20-30% of the deaths of patients with chronic kidney disease with indication to undergo dialysis occur after refusal to continue dialysis, discontinuation of dialysis or inability to offer dialysis on account of local conditions. Contributing factors include aging, increased comorbidity associated with chronic kidney disease, and socioeconomic status. In several occasions nephrologists will intervene, but at times general practitioners or family physicians are on their own. Knowledge of the main etiologies of chronic kidney disease and the metabolic alterations and symptoms associated to end-stage renal disease is an important element in providing patients with good palliative care. This review aimed to familiarize members of multidisciplinary care teams with the metabolic alterations and symptoms arising from chronic kidney disease treated clinically without the aid of dialysis.

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“…No público pediátrico, a inserção dos cuidados paliativos de forma precoce também traz benefícios no prognóstico e seguimento da DRC. Crianças submetidas à diálise e com comorbidades severas são mais hospitalizadas e têm aumento da morbidade (Neto, Moura & Suassuna, 2017). Em crianças e adultos, os cuidados paliativos são promovidos tanto pela equipe multiprofissional -médicos, enfermeiros, psicólogos, técnicos de enfermagem e nutricionista -quanto pelos familiares e amigos.…”

Section: Cuidados Paliativos No Contexto Da Doença Renal Crônica: Importância Início E Inclusão Na Decisão Do Tratamento Dialíticounclassified

Como incluir os cuidados paliativos na formação de médicos nefrologistas: Revisão da literatura

Fernandes

Pinto

Melo

et al. 2021

RSD

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Objetivo: O artigo tem como objetivo apresentar as vantagens dos cuidados paliativos (CP) para pacientes com doença renal crônica (DRC) e evidenciar os conhecimentos necessários aos nefrologistas para oferecer um tratamento holístico e adequado a esses pacientes. Metodologia: Essa revisão foi produzida usando a Pubmed (Biblioteca Nacional Americana de Medicina), a Biblioteca Virtual em Saúde (BVS) e a Scientific Eletronic Library Online (SciELO). A busca avançada teve como descritores: cuidados paliativos, doença renal crônica e planejamento antecipado de cuidados. Posteriormente, filtrou-se os artigos em inglês e português com publicações entre 2015 e 2020, sendo selecionados os mais pertinentes. Resultados: A análise das referências elucidou o CP e o seu papel na DRC, as competências inerentes aos nefrologistas e os principais sintomas dos pacientes com DRC. Conclusão: A instituição do CP, precocemente, é necessária para melhorar a qualidade de vida dos pacientes com DRC, sem restringir às medidas de fim de vida e sem excluir procedimentos intervencionistas. Assim, é indispensável investir na capacitação dos nefrologistas para que atendam às demandas da assistência paliativa em DRC.

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Renouncement of renal replacement therapy: withdrawal and refusal

Cited by 6 publications

References 0 publications

Sociodemographic, Clinical and Biochemical Factors Associated With the Glomerular Filtration Rate in Patients Newly Admitted to Hemodialysis in Sus

Sociodemographic, Clinical and Biochemical Factors Associated With the Glomerular Filtration Rate in Patients Newly Admitted to Hemodialysis in Sus

Conservative management for patients with chronic kidney disease refusing dialysis

Como incluir os cuidados paliativos na formação de médicos nefrologistas: Revisão da literatura

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